Provider Demographics
NPI:1760002042
Name:KANIKI, KAREN YOWMAN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:YOWMAN
Last Name:KANIKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 NE LOOP 820 STE 103
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7211
Mailing Address - Country:US
Mailing Address - Phone:682-360-8652
Mailing Address - Fax:817-537-2036
Practice Address - Street 1:305 NE LOOP 820 STE 103
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-7211
Practice Address - Country:US
Practice Address - Phone:682-360-8652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator